Autopsy Findings and Venous Thromboembolism in Patients With COVID-19: A Prospective Cohort Study

The objective of this prospective cohort study was to validate and compare clinical findings with data from medical autopsy, virtual autopsy, and virological tests of 12 patients who died with a polymerase chain reaction– confirmed diagnosis of COVID-19.

The objective of this prospective cohort study was to validate and compare clinical findings with data from medical autopsy, virtual autopsy, and virological tests of 12 patients who died with a polymerase chain reaction– confirmed diagnosis of COVID-19. Each case was evaluated through a complete autopsy, including post-mortem computed tomography and histopathologic and virological analysis.
The median patient age was 73 years (range, 52 to 87 years) and 75% of patients were male. Coronary heart disease and asthma/chronic obstructive pulmonary disease were the most common comorbid conditions (50% and 25%, respectively). Autopsy revealed deep venous thrombosis in 7/12 patients (58%) in whom venous thromboembolism was not suspected before death; pulmonary embolism was the direct cause of death in 4 patients. Post-mortem computed tomography revealed reticular infiltration of the lungs with severe bilateral, dense consolidation, whereas histomorphologically diffuse alveolar damage was seen in 8 patients. In all patients, SARS–CoV-2 RNA was detected in the lungs in high concentrations; viraemia was evident in 6/10, and 5/12 patients demonstrated high viral RNA titers in the liver, kidney, or heart. The authors concluded that the high incidence of thromboembolic events suggests an important role of COVID-19–induced coagulopathy.
https://www.ncbi.nlm.nih.gov/pubmed/32374815

by Marialuisa Zedde and Francesco Cavallieri